People seeking treatment for heroin addiction face a number of obstacles, including a lack of treatment beds, expensive care, and insurance companies that refuse to pay for inpatient rehab, according to ABC News.
Most insurance companies will not pay for inpatient heroin detoxification or rehab because withdrawal from the drug is generally not deadly, according to Anthony Rizzuto, a provider relations representative at Seafield Center, a rehabilitation clinic on Long Island, N.Y. He says insurance companies either claim the patient does not meet the “criteria for medical necessity” for inpatient care, or they require the patient to first try outpatient rehab and “fail” before being considered for inpatient treatment.
Most experts say inpatient care is often needed for a person addicted to heroin. Withdrawal, which in regular abusers may occur as early as a few hours after the last administration, produces drug craving, restlessness, muscle and bone pain, insomnia, diarrhea and vomiting, cold flashes with goose bumps, kicking movements and other symptoms. Major withdrawal symptoms peak between 48 and 72 hours after the last dose, and subside after about a week. Sudden withdrawal by heavily dependent users who are in poor health can be fatal.
The symptoms of withdrawal are so bad that many people go back to using heroin, often with deadly consequences. Even people who are able to stop using heroin without treatment often relapse. They may overdose because they use as much heroin as they did before, but their system can’t handle the same level of drug as before they went through withdrawal.
Even patients who do get some insurance coverage for heroin treatment generally don’t get 30 days in a residential center. The average duration is 11 to 14 days, according to Tom McLellan, CEO of the nonprofit Treatment Research Institute in Philadelphia. After insurance companies stop paying, facilities discharge patients, even if they are not done with treatment.
The average cost of a 30-day inpatient stay is about $30,000.